Membership Application

Leadership Circle (lifetime membership) $1,000 - Anyone interested in an especially meaningful commitment that lasts a lifetime

Affiliate Membership $150 - Anyone interested in joining the Leadership Greater Hartford Network

Alumni Membership $100 - Program graduates including Leaders On Board placed individuals

Golden Membership $65 - Program graduates who are 65 years or older, or graduates of the Third Age Initiative

Student Membership $65 - For undergraduate and graduate students with a valid university email address

Transitional Alumni $25 - Program graduates who are in-between jobs

First Name: Last Name: Title: Company: Address: City: State: Zip: - Address Type: Email: Preferred Phone: Membership Level:

Leadership Circle - $1000

Affiliate - $150

Alumni - $100

Golden - $65

Student - $65

Transitional Alumni - $25

Check here if you'd like your membership to renew automatically each year (excludes Leadership Circle memberships).

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